Provider Demographics
NPI:1609307099
Name:GHARST, MELISSA LIANE (MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LIANE
Last Name:GHARST
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2313
Mailing Address - Country:US
Mailing Address - Phone:317-494-0774
Mailing Address - Fax:
Practice Address - Street 1:111 E MONROE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2313
Practice Address - Country:US
Practice Address - Phone:317-494-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33007555A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker